Mercurius cyanatus



3. Mr. H -, aet. 19, architect, weakly, nervous constitution, several hours after eating a hearty dinner, took a glass of eau sucree in which was put by mistake a teaspoonful of a saturated solution of cyanide of mercury. A short time after taking the poison, the patient experienced a general feeling of coldness, soon followed by nausea, vomiting, and diarrhoeic evacuations with violent colic. During the evacuations feeling of general prostration, soon amounting to a fainting fit, in which he fell to the floor, where he lay for an indefinite length of time in an unconscious state; he was alone in his room and received no aid. After consciousness had returned he crawled into bed, where he was found next m., 7 hours after taking the poison. Dr. Leon Simon saw him about 10 a. m. Not knowing the cause of the attack, he received an infusion of tea, which was soon after vomited up. At first sight the young man seemed to be suffering from an attack of cholerine; his face was pale, somewhat bluish, and distorted, the eyes sunken, skin icy cold, pulse small, 70 to 76. Tongue pale; violent thirst, but what he drank was immediately vomited; a disagreeable astringent taste in mouth. He had had no evacuation and had not urinated for 2 h. The abdomen was not tympanitic, or particularly sensitive to pressure. Simon thought that the repeated evacuations had carried the poison from the intestinal canal, and prescribed neither emetics nor chemical antidotes, but gave the patient hepar sulph., 3rd dil., with alternate drinks of milk and eliminated water. 6 p. m., patient had vomited twice, not very copiously, but had had much retching; 6 fluid offensive passages. The skin had become warm again; the pulse was quicker and stronger – 90 beats. The tongue continued pale, with a yellowish coating on back part. Scraping in oesophagus; difficult swallowing; pharynx looked red and arborescent. Violent thirst, burning in stomach; epigastrium and (slightly) abdomen painful to pressure. No urine apart from stools. N. was spent sleeplessly. Patient was much excited and talked without cessation. He got angry with his watchers, and talked at random in his rage. He drank much, vomited 6 times, and had 8 stinking green slimy stools; no urine passed. Next m. condition was same as evening before. Skin, hot, somewhat moist; headache; vertigo when sitting up; ringing in ears; tongue redder at edges, coated grey at back. Hepar sulph. continued. Next day condition was improved; he had vomited but once, and had 3 fluid passages much less painful; passed urine once; sleeplessness and excitability same; extremely violent headache. Vertigo and ringing in ears on sitting up. Great weakness. Belladonna 12. 15th. – Sleeplessness and headache same in n., but not so furibund; less thirst; no more vomiting; 6 slimy diarrhoeic stools, with some tenesmus. Pulse increased; skin moderately warm; less vertigo; mucous membrane of mouth affected, gums swollen, covered with a white layer, with a violet – coloured margin; tongue swollen, and covered with tenacious grey coating; entire mucous membrane of mouth and fauces red and arborescent. Nitric acid 6. 16th. – General condition same; fever in n., with sleeplessness and violent headache; no vomiting; no evacuation; condition of mouth somewhat worse. A white transparent layer, resembling mucous syphilitic patches, has formed on palatine arches and tonsils; further, there was present on inner surface of right cheek a round ulcer with grayish base and sharply defined edges, surrounded by a bright red border. Nitric acid 12. 17th and 18th. – Condition the same, except that the ulcer in the mouth had spread, and was covered with a layer of grayish exudation; great thirst, cannot take warm drinks or meat broth, the later seemed to him too salt. Constipation, and some pain in belly; the later is not distended, and not very sensitive to pressure; urine clear but scanty. On 17th patient was left without med. On 18th and 19th he received sulphur 24. He had continuous hiccough for 24 hours; this was at last relieved by nux vomica. 20th. – Condition of mouth improved. Ulcerated surface clean, and is beginning to cicatrise; gums less swollen, less red, and the white coating has disappeared from these and from throat. Less thirst; meat – broth and light soups well received. Constipation; urine more copious; nights are more quite; still patient has not his natural sleep. The neuralgic headache still continues during first part of n. Pulse small and weak, 70 to 75. Patient could sit up yesterday for an hours without being too much fatigued thereby. On 21st improvement continued, but on 22nd there was a sudden return of watery evacuations, which were preceded by violent colic; no urination; tongue is again covered with a grey coating; patient has a very disagreeable metallic taste, a return of the thirst, aversion to food, nausea; pulse accelerated but weak; skin moist and cold, and general prostration,. Arsenicum 12. 23rd. – Symptoms in mouth better; increased diarrhoea; since yesterday, 12 blackish, fluid, very foetid stools, and violent colic; urine scanty and dark. Extreme weakness, pale face, icy – cold skin; small thread – like pulse, 100; thirst moderate; aversion to food. China 6. 24th. – Diarrhoea the same; patient very weak; pulse small; skin moist and icy cold. Hippocratic face; could not sleep at n. on account of frequent evacuations. Carbo veg.24 25th. – But 8 evacuations during past 24 h. They were more yellow; one of them contained some blood. Pulse stronger, 100; skin not so cold, and countenance more natural; less thirst; tongue retains its grey coating. gums less inflamed and swollen, hut teeth painful. Mucous membrane of mouth and pharynx quite clean. Carbo veg.30 26th and 27th. – Considerable improvement. Diarrhoea checked and strength returning. Patient can remain up almost an hours; some return of appetite; patient can take soup; when sitting he complains of pain in rectum and about anus. 29th. – No more diarrhoea, but pains in rectum are becoming unbearable. The parts about anus are swollen, sensitive, and somewhat red; no stool but some black blood is expelled when making the effort. Belladonna 12. 30th. – All symptoms worse; 6 profuse evacuations of blood; patient is again extremely weak; pains in anus continue very severe; around anus small hemorrhoidal tumour, and wart – like elevation on mucous membrane. Rhus tox 18. March 31st, April 1st and 2nd. – The bloody passages, have ceased, but not the pains; besides the above – mentioned symptoms, there is found about the anus a grayish diphtheritic coating, quite similar to that on the inner cheeks; also erosions on mucous membrane; in short, condition of anus was similar to the pathological affection styled ulcerating mucous patches. Mercurius solub.18 3rd. – Aggravation of pain in rectum; extension of ulcers and of diphtheritic coating; ichorous discharge from rectum diffusing the characteristic gangrenous smell, and leaving broad blackish stains on sheets. Lachesis 24. 4th. – Rather less pain, and much less gangrenous odour; discharge from anus still profuse, but more pus – like. Since yesterday m. some pain in calf of left leg; on examination it was found that the veins formed two hard cords, which united a little below the bend of the knee; the slightest touch is very painful. Lachesis 12. 5th, 6th, and 7th. – Improvement daily; discharge from anus growing less and less; it is of a serous nature, and has scarcely any odour. Yesterday patient had a painful passage, but sensitiveness has much decreased. He can now sit on an air – cushion. The leg is much in the same condition, and begins to swell as soon as he is on his feet. 10th. – Discharge is nearly stopped; parts around anus are somewhat red, but there is no swelling or any diphtheritic coating; patient remains up for several hours each day; for 2 day past he has been able to eat and digest meat. Daily, one or two soft stools, but slightly painful. The leg is less painful continues somewhat swollen. No med. 12th. – Condition same as 2 day ago. Lachesis 30. 14th. – Leg is less painful, venous cords having grown much smaller; rectum and anus almost well. Lachesis 30. 18th. – Improvement continues. 28th. – Leg continues somewhat painful; otherwise well. Lachesis 200. 8 day after patient visited Simon. His condition was improved in every way. He could walk more than an hours without fatigue. May 14th. – Simon saw the patient for the last time; he had resumed his usual occupations. (Bull. de la Soc. Medorrhinum Hom. de France, iv, 340).

Experiments on animals

1a. A small bitch received 7 gr. dissolved in distilled water. For 5 m. retching, cramps, alternated with weakness; respiration and heart’s action at first accelerated, then abnormally slow. Death in 10 m. 1b. About 3 gr. were injected into connective tissue of thigh of a dog. In 3 m. retching and spasms, broken from time to time by fits of weakness lasting 3/4 h. The animal then remained weak with tottering gait; the vomiting stopped. In 4 hours all symptoms disappeared. 1c. About 3/5 gr. were injected into the jugular vein of a young dog; he immediately fell on his side; slight spasms, lasting but some seconds; very slow respiration, heart – beats only 32 per m. Respiration and circulation grew slower and slower, and the animal died without spasms in 5 m. 1d. The P. M. changes were of no decided character. Lungs contained little blood, and crepitated; heart was relaxed, and its chambers contained much blood, which was partly fluid. In the dog killed by injection into the jugular, the blood formed very elastic, firm, fibrous coagula in the vena cava ascendens and the iliac veins. In the other animals the blood in the vessels was mostly fluid. The colour of the mucous membrane of the stomach was very variable; in 2 cases there were dark red spots, formed by the union of many small vessels. The same colour, somewhat less marked, was found in a dog which received 12 gr. after fasting 36 h. The same appearance of mucous membrane of stomach and intestines was seen in the dog killed by hypodermic injection. The dog’s stomach was partly filled with food. Another dog, killed in the same way, had eaten nothing for 48 hours; the mucous membrane of stomach and intestines was whitish; he had vomited several times. In all the stomach was closely contracted, except in the one killed, in 10 m. by injection into the jugular vein. In all, without exception, the liver was filled with copious fluid blood. (ORFILA, op. cit.)

Richard Hughes
Dr. Richard Hughes (1836-1902) was born in London, England. He received the title of M.R.C.S. (Eng.), in 1857 and L.R.C.P. (Edin.) in 1860. The title of M.D. was conferred upon him by the American College a few years later.

Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.